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Organization
BLUE WATER PSYCHIATRY
Active
Organization
BLUE WATER PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN MCKINLEY PMHNP-BC (NURSE PRACTITIONER)
(602) 872-8243
Entity
Organization
Contact information
Practice address
2491 E BOSTON ST, GILBERT, AZ 85295-2379
(602) 872-8243
(480) 631-0546
Mailing address
2491 E BOSTON ST, GILBERT, AZ 85295-2379
(602) 872-8243
(480) 631-0546
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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